Evidence map›Paper›PMID 28913712›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2017

Surgical Site Infection Is Associated with Tumor Recurrence in Patients with Extrahepatic Biliary Malignancies.

Stefan Buettner, Cecilia G Ethun, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Matthew Weiss, Ryan C Fields, Bradley Krasnick, Sharon M Weber and 12 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Stefan BuettnerDepartment of Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands.
Cecilia G EthunDepartment of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
George PoultsidesDepartment of Surgery, Stanford University Medical Center, Stanford, CA, USA.
Thuy TranDepartment of Surgery, Stanford University Medical Center, Stanford, CA, USA.
Kamran IdreesDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Chelsea A IsomDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Matthew WeissDepartment of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Ryan C FieldsDepartment of Surgery, Washington University School of Medicine, St Louis, MO, USA.
Bradley KrasnickDepartment of Surgery, Washington University School of Medicine, St Louis, MO, USA.
Sharon M WeberDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Ahmed SalemDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Robert C G MartinDepartment of Surgery, University of Louisville, Louisville, KY, USA.
Charles R ScogginsDepartment of Surgery, University of Louisville, Louisville, KY, USA.
Perry ShenDepartment of Surgery, Wake Forest University, Winston-Salem, NC, USA.
Harveshp D MogalDepartment of Surgery, Wake Forest University, Winston-Salem, NC, USA.
Carl SchmidtDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center, Ohio State University, 395 W. 12th Avenue, Suite 670, Columbus, OH, 43210, USA.
Eliza BealDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center, Ohio State University, 395 W. 12th Avenue, Suite 670, Columbus, OH, 43210, USA.
Ioannis HatzarasDepartment of Surgery, New York University, New York, NY, USA.
Rivfka ShenoyDepartment of Surgery, New York University, New York, NY, USA.
Bas Groot KoerkampDepartment of Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands.
Shishir K MaithelDepartment of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Timothy M PawlikDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center, Ohio State University, 395 W. 12th Avenue, Suite 670, Columbus, OH, 43210, USA. tim.pawlik@osumc.edu.

Funding

Translational Therapeutics Research Program (TT)P30CA016058 · NCI · OHIO STATE UNIVERSITY · PI Jennifer A. Woyach · 1985 to 2026
$132.3M
Vanderbilt Clinical Oncology Research Career Development ProgramK12CA090625 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Debra L. Friedman, Paula Jill Hurley · 2001 to 2026
$16.9M
SURGICAL ONCOLOGY TRAINING GRANTT32CA009621 · NCI · WASHINGTON UNIVERSITY · PI TIMOTHY J. EBERLEIN, William E. Gillanders · 1988 to 2026
$12.9M
Surgical Oncology Training GrantT32CA106183 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI James Richard Goldenring · 2004 to 2026
$6.0M
NCI NIH HHS K12 CA090625NCI NIH HHS P30 CA016058NCI NIH HHS T32 CA009621NCI NIH HHS T32 CA106183
6 · The paper itself

Abstract

backgroundSurgical site infections (SSI) are one of the most common complications after hepato-pancreato-biliary surgery. Infectious complications may lead to an associated immune-modulatory effect that inhibits the body's response to cancer surveillance. We sought to define the impact of SSI on long-term prognosis of patients undergoing surgical resection of extrahepatic biliary malignancies (EHBM).

methodsPatients undergoing surgery for EHBM between 2000 and 2014 were identified using a large, multi-center, national cohort dataset. Recurrence free survival (RFS) was calculated and a multivariable Cox proportional hazards model was utilized to identify potential risk factors for RFS including SSI.

resultsSeven hundred twenty-eight patients included in the analytic cohort; 236 (32.4%) patients had perihilar cholangiocarcinoma, 241 (33.1%) gallbladder cancer, and 251 (34.5%) distal cholangiocarcinoma. A major resection, liver resection, was performed in 205 (28.3%) patients, while 110 (15.2%) patients had a pancreaticoduodenectomy. The overall incidence of morbidity was 55.8%; among the 397 patients who experienced a complication, 161 patients specifically had an SSI. The SSI occurred as an infection of the surgical site (n = 70, 9.6%) or formation of an abscess in the operative bed (n = 91, 12.5%). SSI was associated with long-term survival as patients who experienced an SSI had a median RFS of 19.5 months compared with 30.5 months for those patients who did not have an SSI (HR 1.40, 95% CI 1.08-1.80; p = 0.01). Among 279 patients who had EHBM that had no associated lymph node metastases, well-to-moderate tumor differentiation, as well as an R0 resection margin, SSI remained associated with worse RFS (HR 1.84, 95% CI 1.03-3.29; p = 0.038), as well as overall survival (HR 1.87, 95% CI 1.18-2.97; p = 0.008).

conclusionSSI was a relatively common occurrence following surgery for EHBM as 1 in 10 patients experienced an SSI. In addition to standard tumor-specific factors, the occurrence of postoperative SSI was adversely associated with long-term survival.

Indexed as

AdultAgedBiliary Tract NeoplasmsBiliary Tract Surgical ProceduresCarcinomaCohort StudiesFemaleHumansIncidenceMaleMiddle AgedNeoplasm Recurrence, LocalPrognosisProportional Hazards ModelsRisk FactorsSurgical Wound InfectionCholangiocarcinomaGallbladder cancerRecurrence free survivalSurgical site infection

Identifiers

PMID28913712
PMCPMC5905431

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.